Management of Complications in Laparoscopic Sacrocolpopexy: Focus on Urinary Incontinence

Pelvic organ prolapse (POP) is a prevalent condition worldwide with detrimental effects on patients’ quality of life. Laparoscopic sacrocolpopexy (LSC) has emerged as the gold standard for managing complex and high-grade POP. While anatomical and subjective outcomes have been extensively documented, the management of its associated complications, particularly urinary incontinence, remains challenging. This study evaluates the strategies implemented to address complications arising from LSC, focusing on urinary incontinence. A retrospective multicenter study analyzed 325 patients who underwent LSC using lightweight macroporous Surelift Uplift mesh between 2011 and 2019. Data on perioperative and long-term complications, with emphasis on urinary incontinence management, were extracted from participating centers. Among them, the incidence of new-onset stress urinary incontinence (SUI) postoperatively was 12.9%. A total of 21 patients required further treatment for urinary symptoms, including mid-urethral sling (MUS) procedures in 5.5% and botulinum toxin injections for overactive bladder (OAB) in 0.9%. The findings underscore the importance of proactive and tailored management strategies for urinary incontinence following LSC. While the procedure demonstrates low complication rates and high anatomical success, urinary symptoms require vigilant monitoring and intervention in a two-step procedure for stress incontinence, if needed.